Department of Radiology, Konkuk University School of Medicine, 4-12, Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Korea.
Skeletal Radiol. 2013 Feb;42(2):231-8. doi: 10.1007/s00256-012-1441-2. Epub 2012 May 26.
To compare the rotator interval and capsular dimension as measured on MR arthrography between patients with clinically diagnosed multidirectional instability (MDI) and control subjects with no instability.
We retrospectively reviewed a consecutive series of 658 shoulders that had undergone MR arthrography between 2006 and 2010. Of these, 97 shoulders were included in the present study. These shoulders were divided into two groups according to the clinically established diagnoses. The MDI group comprised 47 shoulders with atraumatic multidirectional shoulder instability, and the control group comprised 50 shoulders with no instability. Two independent observers measured the width and depth of the rotator interval, and the capsular dimensions at the anterior, anteroinferior, inferior, posteroinferior, and posterior regions in the two groups using MR arthrography.
The rotator interval width and depth were significantly greater in the MDI group (width, observer 1, 17.7 mm, observer 2, 17.9 mm; depth, observer 1, 8.9 mm, observer 2, 8.8 mm) than in the control group (width, observer 1, 14.3 mm, observer 2, 14.5 mm; depth, observer 1, 5.9 mm, observer 2, 6.2 mm) (p < .001). The capsular dimensions at the inferior and posteroinferior regions were significantly larger in the MDI group (inferior, observer 1, 27.9 mm, observer 2, 27.8 mm; posteroinferior, observer 1, 27.0 mm, observer 2, 27.1 mm) than in the control group (inferior, observer 1, 25.7 mm, observer 2, 25.3 mm; posteroinferior, observer 1, 23.3 mm, observer 2, 23.6 mm) (p < .05). A width greater than 15.2 mm or a depth greater than 6.4 mm of the rotator interval, suggesting MDI, had sensitivities of 81 and 92 % for observer 1, and 79 and 94 % for observer 2, and specificities of 66 and 72 % for observer 1, and 62 and 66 % for observer 2, respectively.
Measurements of the rotator interval and the size of the distended inferior and posteroinferior joint capsule on MR arthrography are greater in shoulders with clinical MDI than in stable shoulders.
比较临床诊断为多向性不稳定（MDI）的患者与无不稳定的对照患者在磁共振关节造影术中测量的旋转间隔和囊状尺寸。
我们回顾性分析了 2006 年至 2010 年间连续进行磁共振关节造影的 658 例肩部。其中，97 例纳入本研究。根据临床诊断，这些肩部分为两组。MDI 组包括 47 例无创伤性多向性肩不稳定患者，对照组包括 50 例无不稳定患者。两名独立观察者使用磁共振关节造影术测量两组的旋转间隔宽度和深度，以及前、前下、下、后下和后区域的囊状尺寸。
MDI 组（观察者 1 为 17.7mm，观察者 2 为 17.9mm；观察者 1 为 8.9mm，观察者 2 为 8.8mm）的旋转间隔宽度和深度明显大于对照组（观察者 1 为 14.3mm，观察者 2 为 14.5mm；观察者 1 为 5.9mm，观察者 2 为 6.2mm）（p<0.001）。MDI 组的下和后下区域的囊状尺寸明显大于对照组（观察者 1 为 27.9mm，观察者 2 为 27.8mm；观察者 1 为 27.0mm，观察者 2 为 27.1mm）（p<0.05）。旋转间隔宽度大于 15.2mm 或深度大于 6.4mm，提示 MDI，观察者 1 的敏感性为 81%和 92%，特异性为 66%和 72%；观察者 2 的敏感性为 79%和 94%，特异性为 62%和 66%。
磁共振关节造影术测量的旋转间隔和扩张的下后关节囊的大小在临床 MDI 肩部大于稳定肩部。
